﻿<%@ Page Title="" Language="C#" MasterPageFile="~/LivingWellClinic.Master" AutoEventWireup="true" CodeBehind="usercreation.aspx.cs" Inherits="livingwellclinic.WebForm2" %>
<asp:Content ID="Content1" ContentPlaceHolderID="title" runat="server">
</asp:Content>
<asp:Content ID="Content2" ContentPlaceHolderID="head" runat="server">
    <style type="text/css">

        .style1
        {
            width: 302px;
            margin-right: 0px;
            height: 352px;
        }
        .style9
        {
            text-align: center;
        }
        .style14
        {
            width: 366px;
            text-align: left;
        }
        .style3
        {
            width: 17px;
        }
        .style5
        {
            color: #FF0000;
        }
        .style13
        {
            text-align: left;
        }
        .style15
        {
            width: 333px;
            text-align: left;
            height: 21px;
        }
        .style16
        {
            width: 17px;
            height: 21px;
        }
        .style17
        {
            height: 21px;
            width: 119px;
        }
        .style18
        {
            width: 119px;
        }
        </style>
</asp:Content>
<asp:Content ID="Content3" ContentPlaceHolderID="body" runat="server">
    <table class="style14" __designer:mapid="4e">
        <tr __designer:mapid="4f">
            <td class="style9" colspan="2" __designer:mapid="50">
                            Please Enter Your Personal Information</td>
            <td __designer:mapid="51" class="style18">
                &nbsp;</td>
        </tr>
        <tr __designer:mapid="52">
            <td class="style14" __designer:mapid="53">
                <asp:Label ID="NameLabel" runat="server" Text="First Name:"></asp:Label>
                            *</td>
            <td class="style3" __designer:mapid="55">
                <asp:TextBox ID="NameTextBox" runat="server" style="margin-left: 0px" 
                                Width="174px"></asp:TextBox>
            </td>
            <td __designer:mapid="57" class="style18">
                <asp:RequiredFieldValidator ID="NameRequiredFieldValidator" runat="server" 
                                ControlToValidate="NameTextBox" CssClass="style5" 
                                ErrorMessage="Please enter your name" ValidationGroup="Submit">*</asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr __designer:mapid="59">
            <td class="style14" __designer:mapid="5a">
                <asp:Label ID="Label1" runat="server" Text="MI"></asp:Label>
            </td>
            <td class="style3" __designer:mapid="5c">
                <asp:TextBox ID="middleintialtxt" runat="server" style="margin-left: 0px" 
                                Width="45px"></asp:TextBox>
            </td>
            <td __designer:mapid="5e" class="style18">
                <asp:RequiredFieldValidator ID="NameRequiredFieldValidator0" runat="server" 
                                ControlToValidate="NameTextBox" CssClass="style5" 
                                ErrorMessage="Please enter your middle intial" 
                    ValidationGroup="Submit">*</asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr __designer:mapid="60">
            <td class="style14" __designer:mapid="61">
                <asp:Label ID="Label2" runat="server" Text="Last Name"></asp:Label>
            </td>
            <td class="style3" __designer:mapid="63">
                <asp:TextBox ID="lastnametxt" runat="server" style="margin-left: 0px" 
                                Width="172px"></asp:TextBox>
            </td>
            <td __designer:mapid="65" class="style18">
                <asp:RequiredFieldValidator ID="NameRequiredFieldValidator1" runat="server" 
                                ControlToValidate="NameTextBox" CssClass="style5" 
                                ErrorMessage="Please enter your last  name" 
                    ValidationGroup="Submit">*</asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr __designer:mapid="67">
            <td class="style14" __designer:mapid="68">
                <asp:Label ID="Address1Label" runat="server" Text="Address (line1):"></asp:Label>
                            *</td>
            <td class="style3" __designer:mapid="6a">
                <asp:TextBox ID="Address1TextBox" runat="server" Width="173px"></asp:TextBox>
            </td>
            <td __designer:mapid="6c" class="style18">
                <asp:RequiredFieldValidator ID="AddressRequiredFieldValidator" runat="server" 
                                ControlToValidate="Address1TextBox" CssClass="style5" 
                                ErrorMessage="Please enter your address" 
                    ValidationGroup="Submit">*</asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr __designer:mapid="6e">
            <td class="style14" __designer:mapid="6f">
                <asp:Label ID="Address2Label" runat="server" Text="Address (line2):"></asp:Label>
            </td>
            <td class="style3" __designer:mapid="71">
                <asp:TextBox ID="Address2TextBox" runat="server" Width="200px"></asp:TextBox>
            </td>
            <td __designer:mapid="73" class="style18">
                &nbsp;</td>
        </tr>
        <tr __designer:mapid="74">
            <td class="style14" __designer:mapid="75">
                <asp:Label ID="CityLabel" runat="server" Text="City:"></asp:Label>
                            *</td>
            <td class="style3" __designer:mapid="77">
                <asp:TextBox ID="CityTextBox" runat="server" Width="200px"></asp:TextBox>
            </td>
            <td __designer:mapid="79" class="style18">
                <asp:RequiredFieldValidator ID="CityRequiredFieldValidator" runat="server" 
                                ControlToValidate="CityTextBox" CssClass="style5" 
                                ErrorMessage="Please enter your city" ValidationGroup="Submit">*</asp:RequiredFieldValidator>
            </td>
        </tr>
        <tr __designer:mapid="7b">
            <td class="style15" __designer:mapid="7c">
                <asp:Label ID="StateLabel" runat="server" Text="State:"></asp:Label>
                            *</td>
            <td class="style16" __designer:mapid="7e">
                <asp:DropDownList ID="DropDownListState" runat="server" Height="21px" 
                    Width="139px">
    <asp:ListItem Value="NA">None</asp:ListItem>
	<asp:ListItem Value="AL">Alabama</asp:ListItem>
	<asp:ListItem Value="AK">Alaska</asp:ListItem>
	<asp:ListItem Value="AZ">Arizona</asp:ListItem>
	<asp:ListItem Value="AR">Arkansas</asp:ListItem>
	<asp:ListItem Value="CA">California</asp:ListItem>
	<asp:ListItem Value="CO">Colorado</asp:ListItem>
	<asp:ListItem Value="CT">Connecticut</asp:ListItem>
	<asp:ListItem Value="DC">District of Columbia</asp:ListItem>
	<asp:ListItem Value="DE">Delaware</asp:ListItem>
	<asp:ListItem Value="FL">Florida</asp:ListItem>
	<asp:ListItem Value="GA">Georgia</asp:ListItem>
	<asp:ListItem Value="HI">Hawaii</asp:ListItem>
	<asp:ListItem Value="ID">Idaho</asp:ListItem>
	<asp:ListItem Value="IL">Illinois</asp:ListItem>
	<asp:ListItem Value="IN">Indiana</asp:ListItem>
	<asp:ListItem Value="IA">Iowa</asp:ListItem>
	<asp:ListItem Value="KS">Kansas</asp:ListItem>
	<asp:ListItem Value="KY">Kentucky</asp:ListItem>
	<asp:ListItem Value="LA">Louisiana</asp:ListItem>
	<asp:ListItem Value="ME">Maine</asp:ListItem>
	<asp:ListItem Value="MD">Maryland</asp:ListItem>
	<asp:ListItem Value="MA">Massachusetts</asp:ListItem>
	<asp:ListItem Value="MI">Michigan</asp:ListItem>
	<asp:ListItem Value="MN">Minnesota</asp:ListItem>
	<asp:ListItem Value="MS">Mississippi</asp:ListItem>
	<asp:ListItem Value="MO">Missouri</asp:ListItem>
	<asp:ListItem Value="MT">Montana</asp:ListItem>
	<asp:ListItem Value="NE">Nebraska</asp:ListItem>
	<asp:ListItem Value="NV">Nevada</asp:ListItem>
	<asp:ListItem Value="NH">New Hampshire</asp:ListItem>
	<asp:ListItem Value="NJ">New Jersey</asp:ListItem>
	<asp:ListItem Value="NM">New Mexico</asp:ListItem>
	<asp:ListItem Value="NY">New York</asp:ListItem>
	<asp:ListItem Value="NC">North Carolina</asp:ListItem>
	<asp:ListItem Value="ND">North Dakota</asp:ListItem>
	<asp:ListItem Value="OH">Ohio</asp:ListItem>
	<asp:ListItem Value="OK">Oklahoma</asp:ListItem>
	<asp:ListItem Value="OR">Oregon</asp:ListItem>
	<asp:ListItem Value="PA">Pennsylvania</asp:ListItem>
	<asp:ListItem Value="RI">Rhode Island</asp:ListItem>
	<asp:ListItem Value="SC">South Carolina</asp:ListItem>
	<asp:ListItem Value="SD">South Dakota</asp:ListItem>
	<asp:ListItem Value="TN">Tennessee</asp:ListItem>
	<asp:ListItem Value="TX">Texas</asp:ListItem>
	<asp:ListItem Value="UT">Utah</asp:ListItem>
	<asp:ListItem Value="VT">Vermont</asp:ListItem>
	<asp:ListItem Value="VA">Virginia</asp:ListItem>
	<asp:ListItem Value="WA">Washington</asp:ListItem>
	<asp:ListItem Value="WV">West Virginia</asp:ListItem>
	<asp:ListItem Value="WI">Wisconsin</asp:ListItem>
	<asp:ListItem Value="WY">Wyoming</asp:ListItem>
</asp:DropDownList>&nbsp;</td>
            <td __designer:mapid="80" class="style17">
                <asp:CustomValidator ID="ddlvad" runat="server" 
                    ControlToValidate="DropDownListState" ErrorMessage="Please select a State" 
                    style="color: #FF0000" ValidationGroup="Submit">*</asp:CustomValidator>
            </td>
        </tr>
        <tr __designer:mapid="82">
            <td class="style14" __designer:mapid="83">
                <asp:Label ID="ZIPLabel" runat="server" Text="ZIP:"></asp:Label>
                            *</td>
            <td class="style3" __designer:mapid="85">
                <asp:TextBox ID="ZIPTextBox" runat="server" Width="200px"></asp:TextBox>
            </td>
            <td __designer:mapid="87" class="style18">
                <asp:RequiredFieldValidator ID="ZipRequiredFieldValidator" runat="server" 
                                ControlToValidate="ZIPTextBox" CssClass="style5" 
                                ErrorMessage="Please enter your ZIP code" 
                    ValidationGroup="Submit">*</asp:RequiredFieldValidator>
                <asp:RegularExpressionValidator ID="ZipRegularExpressionValidator" 
                                runat="server" ControlToValidate="ZIPTextBox" CssClass="style5" 
                                ErrorMessage="Please enter a valid US ZIP code" 
                                ValidationExpression="\d{5}(-\d{4})?">*</asp:RegularExpressionValidator>
            </td>
        </tr>
        <tr __designer:mapid="8a">
            <td class="style14" __designer:mapid="8b">
                <asp:Label ID="PhoneLabel" runat="server" Text="Phone:"></asp:Label>
            </td>
            <td class="style3" __designer:mapid="8d">
                <asp:TextBox ID="PhoneTextBox" runat="server" Width="200px"></asp:TextBox>
            </td>
            <td __designer:mapid="8f" class="style18">
                <asp:RegularExpressionValidator ID="PhoneRegularExpressionValidator" 
                                runat="server" ControlToValidate="PhoneTextBox" CssClass="style5" 
                                ErrorMessage="Please enter a valid phone number" 
                                ValidationExpression="((\(\d{3}\) ?)|(\d{3}-))?\d{3}-\d{4}" 
                                ValidationGroup="Submit">*</asp:RegularExpressionValidator>
            </td>
        </tr>
        <tr __designer:mapid="91">
            <td class="style13" colspan="3" __designer:mapid="92">
                <asp:ValidationSummary ID="ValidationSummary1" runat="server" 
                                style="color: #FF0000" ValidationGroup="Submit" />
            </td>
        </tr>
    </table>
    <asp:Label ID="lblinformation" runat="server"></asp:Label>
    <br />
    <asp:Button ID="Button1" runat="server" Text="Save Changes" 
        ValidationGroup="Submit" onclick="Button1_Click" />
    <br />
</asp:Content>
